Organization
G AND M PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE ROBERTSON WAMBLE (CPHT MANAGER)
(662) 236-2222
Entity
Organization
Contact information
Practice address
2159 S LAMAR BLVD, OXFORD, MS 38655-5223
(662) 236-2222
(662) 236-2213
Mailing address
2159 S LAMAR BLVD, OXFORD, MS 38655-5223
(662) 236-2222
(662) 236-2213
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
13861GO
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440904
—
MS
Enumeration date
05/29/2008
Last updated
06/18/2008
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